Ga-68-DOTATATE positron emission tomography/ computed tomography scan in the detection of bone metastases in pediatric neuroendocrine tumors

Aim: The aim of this study is to evaluate the role of Ga-68-DOTATATE positron emission tomography/computed tomography (PET/CT) scan for the detection of bone metastases in pediatric neuroendocrine tumors (NETs) and to compare it with CT scan. Materials and Methods: A total of 30 patients (18 were males and 12 were females; age range: 1-18 years; mean age 7.6 years) with histologically confirmed NETs referred to our department were retrospectively analyzed. All patients underwent Ga-68-DOTATATE PET/CT scan at the time of diagnosis for primary staging. Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data. Imaging results were analyzed on a per-patient and on a per-lesion basis. Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard. Results: Out of the 30 patients, 17 had no evidence of bone metastases on any imaging modality or on clinical follow-up while the rest of 13 patients showed evidence of bone metastases (nine showing positivity both on Ga-68-DOTATATE PET and CT scan while four showing positivity only on Ga-68-DOTATATE PET). Compared with CT scan, Ga-68-DOTATATE PET detected bone metastases at a significantly higher rate (P - 0.0039). On a per lesion analysis, out of a total of 225 lesions detected by Ga-68-DOTATATE PET, only 84 lesions could be detected by CT scan. Conclusion: Ga-68-DOTATATE PET/CT scan is more useful than CECT scan for the early detection of bone metastases in pediatric NETs.